Silva Trevor, Wagler Amy, Nelson Daniel, O'Connor Victoria
Department of Surgery, Riverside University Health System, Moreno Valley, California, USA.
Department of Mathematical Sciences, The University of Texas at El Paso, El Paso, Texas, USA.
J Surg Oncol. 2023 Dec;128(7):1080-1086. doi: 10.1002/jso.27417. Epub 2023 Aug 17.
Non-physiological factors tied to the disease process may drive the diminished quality of life (QoL) after pancreatoduodenectomy (PD). We compared postoperative QoL among patients undergoing PD for either benign or malignant pathology.
From 2012 to 2021, 228 patients underwent PD in a large healthcare system. Eighty-two patients (36.0%) were interviewed using the EORTC QLQ-C30 questionnaire. A minimum of 6 months after surgery was required for the survey. QoL outcomes were compared based on diagnosis (benign vs. malignant).
Patient mean age was 65 years (21-82), and forty-seven (57%) were men. Most patients underwent surgery for cancer, 76% (n = 62). Grade B postoperative pancreatic fistula incidence was higher in benign cases (30% vs. 6.5%, p = 0.024). Weight loss was more common in malignancy (79% vs. 50%, p = 0.016). Carcinoma patients felt less useful, hopeful, reported less control of their life and certainty of the future, and were less satisfied with their appearance. Carcinoma patients also reported diminished memory, fear of relapse, and greater financial burden.
Long-term QoL is inferior in PD patients with carcinoma and is driven by the psychological and socioeconomic implications of malignancy. Supportive resources for pancreas cancer patients should be evaluated and optimized.
与疾病进程相关的非生理因素可能导致胰十二指肠切除术（PD）后生活质量（QoL）下降。我们比较了因良性或恶性病变接受PD治疗的患者术后的生活质量。
2012年至2021年，在一个大型医疗系统中，228例患者接受了PD手术。82例患者（36.0%）使用欧洲癌症研究与治疗组织QLQ-C30问卷进行了访谈。调查要求在手术后至少6个月进行。根据诊断（良性与恶性）比较生活质量结果。
患者平均年龄为65岁（21-82岁），47例（57%）为男性。大多数患者因癌症接受手术，占76%（n = 62）。良性病例中B级术后胰瘘发生率较高（30%对6.5%，p = 0.024）。体重减轻在恶性肿瘤患者中更常见（79%对50%，p = 0.016）。癌症患者感觉自己用处更小、希望更小，报告对生活的控制感和对未来的确定性更低，对自己的外表也不太满意。癌症患者还报告记忆力下降、害怕复发和经济负担更重。
癌症患者行PD后的长期生活质量较差，且受恶性肿瘤的心理和社会经济影响。应评估并优化针对胰腺癌患者的支持资源。
